Individual provider Active NPI

Heather S Hall, PA-C

  • Physician Assistant
  • Hagerstown, MD
National Provider Identifier
1801814116
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003281 Issued in MD
Practice address
1141 Opal CT
Hagerstown, MD 21740-5976
Phone
(301) 791-6666
NPI assigned
Jul 17, 2006
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003281 MD Primary

Addresses

Primary practice location

1141 Opal CT
Hagerstown, MD 21740-5976

Mailing address

1141 Opal CT
Hagerstown, MD 21740-5976
Phone (301) 791-6666

Other identifiers 2

IdentifierTypeStateIssuer
926580505MedicaidMD
926580509MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060508000371 MD Practitioner - Physician Assistant 5799796645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0003281MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Nov 12, 2016 Accepting new patients
Mir Neurology Center PA CurrentSince Jun 20, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 12, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Opal Court Pediatrics, P.a. PastSince Nov 15, 2020 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

3430 Worthington Blvd
Ste 103
Frederick, MD 21704
Phone (240) 215-6900

610 Solarex Ct
#2
Frederick, MD 21703

610 Solarex Ct
Fl Second
Frederick, MD 21703

11110 Medical Campus Rd
Ste 151
Hagerstown, MD 21742
Phone (301) 722-3777

1141 Opal Ct
Ste A
Hagerstown, MD 21740
Phone (301) 791-6666

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Interoperability endpoints

  • Direct secure messaging: heather.hall.1@17459.direct.athenahealth.com
  • Direct secure messaging: heatherhall@mncmd.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/17459/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1801814116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405976",
            "telephone_number": "301-791-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405976",
            "telephone_number": "301-791-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "HEATHER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580505",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580509",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.